Pharmacists across the state are facing tough times, whether it鈥檚 more of their patients ordering prescriptions online or lower profits on the drugs they dispense. Independent pharmacists are worried about staying in business.
Harsh Patel owns Care Rx Pharmacy in Tallahassee. He used to manage a pharmacy for a big chain, but says he loves his freedom.
鈥淭his is my seventh year running,鈥� he says, 鈥渁nd I鈥檓 proud to take care of my patients and try to do anything and everything to take care of them.鈥�
But Patel says he loses money on many of the prescriptions he fills 鈥� less on generics than on name-brand drugs. And that loss has increased within the past year.
鈥淚 don鈥檛 know why, because nothing has changed. It鈥檚 the same pharmacy, same patient population,鈥� he says. 鈥淚 used to fill a prescription for Fycompa, and Fycompa I used to lose 20, 30 dollars. Now I lose 70, 80 dollars on a Fycompa prescription. And it just does not go well in my brain.鈥�
Patel says it鈥檚 even affected the big chains. He says that鈥檚 evident when pharmacies across the board are cutting back their hours.
鈥淓very single chain is noticing this reimbursement cutting back, so they are cutting back the number of hours they are open,鈥� he says. 鈥淲ho is going to suffer? The patient who is needing their crucial medication.鈥�
Dr. Ancil Carruthers is the director of Pharmacy Services and an assistant professor at Florida A&M University鈥檚 College of Pharmacy and Pharmaceutical Sciences. He says the costs of running a pharmacy are complex.
鈥淛ust like most patients think we order the drug, it costs money and it comes in,鈥� says Carruthers. 鈥淏ut that process, as simple as it may sound, has a lot of different elements to it that affects the retail space a lot.鈥�
Instead, says Carruthers, the insurance company might only give the pharmacist a reimbursement that鈥檚 less than the drug cost. The pharmacy could lose, say, $1,200 a year on that one prescription 鈥� and there could be dozens of patients with the same issue, costing the pharmacy a substantial sum over the course of a year.
鈥淎nd so, that patient is none the wiser. They went to the doctor today, got a new prescription, got a new diagnosis, trying a new therapy,鈥� he says. 鈥淎nd they鈥檙e thinking, 鈥楳y pharmacy is going to get the insurance money and get reimbursed and everything鈥檚 the same.鈥� But that pharmacist or that pharmacy manager has to realize, 鈥極h. This patient who has been with me for awhile, someone I know their name, I know their family, I know their kids 鈥� they鈥檙e going to cost me 100 bucks a month.鈥�
Last year, the Florida Legislature passed a bill aimed at boosting transparency for pharmacy benefit managers, but Carruthers says other elements could be at play when pharmacists don鈥檛 get reimbursed adequately.
鈥淚t could be the PBMs. It could be the wholesalers and the price they鈥檙e giving us. So, those numbers are variable, too,鈥� he says. 鈥淚t鈥檚 just a lot of different elements in the system all at once, coming together to make it tough and challenging.鈥�
He says the question of whether the pharmacy industry is tough is always relative.
鈥淚t is a new and challenging way to go about it. You have to think on your feet, see where the reimbursements are and just learn and evolve with the tough times. So, it鈥檚 not that it鈥檚 impossible,鈥� he says. 鈥淚t鈥檚 not that it鈥檚 one element over the other. It鈥檚 just, it鈥檚 a lot of things that come together that makes it tough.鈥�
According to Fortune Magazine, in 2023 there were 4,550 fewer pharmacies than a decade earlier. And the National Community Pharmacists Association said in February that several thousand more local pharmacies, up to a third of its members, could close this year.
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